Outside, hundreds of people lined up in the chilly darkness, each with a number and a need for health services. Among them was David Fields, 28, of Morristown, Tenn., who has ''gone years'' without seeing a dentist and needed dental work. Fields held number 121.
At 6 a.m., the cafeteria door opened. After waiting overnight in the parking lot, people with the lowest numbers were directed to the registration table.
It marked the opening of a free weekend clinic run by Remote Area Medical, a volunteer-powered nonprofit that annually organizes about 20 mobile ''expeditions'' to treat America's uninsured. The group holds several each year in Tennessee, RAM's home base.
The Maryville clinic in March featured 400 medical volunteers, including Brenda Kimmons, a nurse who came 180 miles from Inman, S.C. "These people are in need of health care,'' she said. Her motivation as a volunteer: "I can make a difference in people's lives.''
The Saturday throng of patients clearly showed that plenty of people are in need of the care. An estimated 46 million Americans have no health insurance, and millions more have coverage with high deductibles or huge gaps in coverage, and can't afford medical costs out of pocket. Volunteer Helen Roth, 68, of nearby Knoxville, who coordinates the organization's nurses, said a rising demand for free services reflects growing joblessness.
Free mobile clinics draw crowds of uninsured
Hundreds of people line up in front of the local high school on a Saturday in Maryville, Tenn., in order to see Remote Area Medical's staff of doctors, dentists and eye specialists.
"These people are not homeless,'' she said. "They're working-class people.'' But many have lost a job and health care and RAM "has stepped up to the plate,'' she said. The Maryville clinic coincided with Congress' final votes on health care reform, which Roth said ''is absolutely necessary.''
Urgent Care in the Auditorium
Joining the volunteer physicians, nurses, and dentists were U.S. public health service workers, who provided health information and flu shots in the hallways, besides helping treat people. Many of the patients have chronic medical conditions such as high blood pressure, diabetes and obesity, said Barry Sprouse, an EMT from Nashville who ran the medical area.
By mid-morning, in fact, an overweight man collapsed while in line for medical care and was evacuated to a local emergency room.
Among the medical patients was Mary Jones of Lenoir City, Tenn., 43. She lost insurance three years ago. "I can't afford to go to a regular doctor,'' she said. Her husband works and has insurance, but the premium is too expensive to add her to the policy, she said. "It's been three years since I saw a doctor,'' Jones said. RAM "is a blessing.''
Darrell Hill, 53, of Spring City, Tenn., arrived in the parking lot at midnight. Self-employed, he also lacked health insurance. "My blood pressure is high,'' he said, adding that he needed dental care for a cracked tooth.
Similar Crowds in Africa, Honduras
The driving force behind RAM is Stan Brock, who launched the nonprofit in 1985, after seeing the absence of medical care in the Amazon.
"When we go to Guatemala, Honduras and Africa, we see similar crowds of people who can't afford the care they need,'' he said. But now, ironically, most of RAM's work takes place in the U.S.
Brock said he hopes health care reform succeeds so well that there's no need for these expeditions in America.
Overall, RAM has treated more than 350,000 people.
One large hurdle, he said, is that many states don't allow medical professionals without a license in that state to provide care at a free clinic. So later this month, when the organization has an expedition in Los Angeles, only medical professionals licensed in California will provide care. RAM treated 6,000 patients in L.A. last summer but had to turn more away, Brock said, because of the licensing problem.
Medical care often isn't the biggest draw. The vision area drew rows of people in chairs along a hallway. Patients received a prescription, then picked out frames among dozens of choices along a table. The lenses were ground in a large truck parked outside. At the end of the line, people were fitted by technicians and walked away with a pair of glasses.
One such customer was Alma Acuff, 70, of Walland, Tenn. who received her first pair of glasses at the RAM clinic. Acuff, who is retired, has Medicare insurance but no vision benefits. "I can't afford glasses after my husband passed away last year,'' she said.
Huge Demand for Dental Work
But the busiest scene of the weekend came on the floor of a large gymnasium, where about 40 dental chairs held a steady flow of patients.
Waiting in gym bleachers, like spectators, were people such as Jeffrey Tester, 34, of Knoxville, a construction worker with no health insurance. Tester said he was hoping to have four teeth pulled. "I've been in pain for about three weeks,'' he said.
The totals for RAM's Maryville weekend: 842 patients seen. Total value of the care delivered: $240,000. 399 pairs of glasses made. 696 teeth extracted. Ron Brewer, state director for RAM, said the clinic operated smoothly. "Even if we treat 10 people, it's a success.''
Dental patient Pam Durham would agree. Durham, 47, came from Chattanooga with a cracked tooth, which had caused pain for two years. Recently she lost her waitress job. "I'm very grateful they're doing this,'' she said.